Subjects -> HEALTH AND SAFETY (Total: 1535 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (721 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (387 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (108 journals)
    - PHYSICAL FITNESS AND HYGIENE (128 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (721 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
Acta Informatica Medica     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 27)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 2)
African Health Sciences     Open Access   (Followers: 4)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 43)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 6)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 19)
American Journal of Health Education     Hybrid Journal   (Followers: 34)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 10)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 269)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 7)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 12)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 4)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 8)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 5)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 12)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 4)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 50)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 22)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 23)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 1)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 4)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 5)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 24)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 22)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 8)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 3)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 14)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 17)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 4)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gestão e Desenvolvimento     Open Access   (Followers: 1)
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 4)
Global Health Journal     Open Access   (Followers: 1)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 8)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 13)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 4)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 68)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)

        1 2 3 4 | Last

Similar Journals
Journal Cover
American Journal of Health Promotion
Journal Prestige (SJR): 0.807
Citation Impact (citeScore): 1
Number of Followers: 34  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0890-1171 - ISSN (Online) 2168-6602
Published by Sage Publications Homepage  [1089 journals]
  • In Briefs
    • Pages: 471 - 474
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 471-474, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:43Z
      DOI: 10.1177/0890117120925619
      Issue No: Vol. 34, No. 5 (2020)
       
  • The Art of Health Promotion: linking research to practice
    • Authors: Sara S. Johnson, Jennifer Moss, Amaryllis Sánchez Wohlever, Alexandria Blacker, Shimi Kang
      Pages: 563 - 575
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 563-575, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:37:02Z
      DOI: 10.1177/0890117120920488
      Issue No: Vol. 34, No. 5 (2020)
       
  • TheEditor’s Desk: Burnout
    • Authors: Sara S. Johnson
      Pages: 563 - 564
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 563-564, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:14Z
      DOI: 10.1177/0890117120920488a
      Issue No: Vol. 34, No. 5 (2020)
       
  • Rethinking Burnout: When Self Care Is Not the Cure
    • Authors: Jennifer Moss
      Pages: 565 - 568
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 565-568, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:15Z
      DOI: 10.1177/0890117120920488b
      Issue No: Vol. 34, No. 5 (2020)
       
  • “Burnout” in the Workplace: Strategies, Omissions, and Lessons
           From Wounded Healers
    • Authors: Amaryllis Sánchez Wohlever
      Pages: 568 - 571
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 568-571, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:15Z
      DOI: 10.1177/0890117120920488c
      Issue No: Vol. 34, No. 5 (2020)
       
  • Activating Teams to Fight Burnout and Create Joy in Work
    • Authors: Alexandria Blacker
      Pages: 571 - 573
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 571-573, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:05Z
      DOI: 10.1177/0890117120920488d
      Issue No: Vol. 34, No. 5 (2020)
       
  • The Power of Play
    • Authors: Shimi Kang
      Pages: 573 - 575
      Abstract: American Journal of Health Promotion, Volume 34, Issue 5, Page 573-575, June 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T11:36:05Z
      DOI: 10.1177/0890117120920488e
      Issue No: Vol. 34, No. 5 (2020)
       
  • Expanding Contraception Access for Women With Opioid-Use Disorder: A
           Qualitative Study of Opportunities and Challenges
    • Authors: Emily A. Hurley, Alex Duello, Sarah Finocchario-Kessler, Kathy Goggin, Stephani Stancil, Rachel P. Winnograd, Melissa K. Miller
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:As almost nine in ten pregnancies among women with opioid use disorder (OUD) are unintended, expanding access to contraception is an underutilized but potentially effective strategy in increasing reproductive agency and reducing the overall burden of neonatal abstinence syndrome. We aimed to identify where and how contraceptive services could be integrated into existing points-of-contact for women with OUD.Approach:In-depth qualitative interviews.Setting:Three diverse catchment areas in Missouri.Participants:Women with OUD (n = 15) and professional stakeholders (n = 16) representing five types of existing OUD service points: syringe exchange programs, recovery support programs, substance use treatment programs, emergency departments, and Federally Qualified Health Centers.Method:Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software.Results:Six themes emerged as essential components for integrating contraceptive services into existing points-of-contact for women with OUD: (1) reach women with unmet need; (2) provide free or affordable contraception; (3) maximize service accessibility; (4) provide patient-centered care; (5) employ willing, qualified contraceptive providers; and (6) utilize peer educators. Participants affirmed the overall potential benefit of contraceptive service integration and illuminated various opportunities and challenges relevant to each type of existing service point.Conclusion:As health promotion initiatives look to increase access to contraception among women with OUD, these six’ participant-identified components offer essential guidance in selecting advantageous points-of-contact and addressing remaining gaps in services.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-29T09:26:35Z
      DOI: 10.1177/0890117120927327
       
  • Impact of Disadvantaged Neighborhoods and Lifestyle Factors on Adult
           Obesity: Evidence From a 5-Year Cohort Study in Australia
    • Authors: Syed Afroz Keramat, Khorshed Alam, Jeff Gow, Stuart J. H. Biddle
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aims to investigate the impact of disadvantaged neighborhoods and lifestyle factors on obesity among Australian adults.Design:Quantitative, longitudinal research design.Setting:Cohort.Sample:Data for this study came from a cohort of 10 734 adults (21 468 observations) who participated in the Household, Income and Labour Dynamics in Australia survey. The participants were interviewed at baseline in 2013 and were followed up in 2017.Measures:Generalized Estimating Equation model with logistic link function was employed to examine within-person changes in obesity due to disadvantaged neighborhoods and lifestyle factors at 2-time points over a 4-year follow-up period.Results:Adults living in the most disadvantaged area were 1.22 (odds ratio [OR]: 1.22, 95% CI: 1.08-1.38) and 1.30 (OR: 1.30, 95% CI: 1.20-1.42) times, respectively, more prone to be overweight and obese compared with peers living at least disadvantaged area. Study results also revealed that adults who consume fruits regularly and perform high levels of physical activity were 6% (OR: 0.94, 95% CI: 0.91-0.98) and 12% (OR: 0.88, 95% CI: 0.85-0.92) less likely to be obese, respectively, compared to their counterparts. Current alcohol drinkers were 1.07 (OR: 1.07, 95% CI: 1.01-1.13) times more likely to be obese compared to peers not consuming alcohol. Highly psychologically distressed adults were 1.08 times (OR: 1.08, 95% CI: 1.02-1.13) more likely to be obese than their peers.Conclusion:This study contributes to the literature regarding disadvantaged neighborhoods and lifestyle factors, which have an influence on adult obesity rates and thus help health decision-makers to formulate effective obesity prevention strategies.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-27T11:06:52Z
      DOI: 10.1177/0890117120928790
       
  • Socioenvironmental Risk Factors for Adolescent Marijuana Use in a United
           States-Mexico Border Community
    • Authors: Elizabeth Salerno Valdez, Luis Valdez, Josephine Korchmaros, David O. Garcia, Sally Stevens, Samantha Sabo, Scott Carvajal
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:We examined how socioenvironmental risk factors unique to the United States-Mexico border, defined as border community and immigration stress, normalization of drug trafficking, and perceived disordered neighborhood stress, contribute to tobacco, alcohol, and marijuana use among adolescents residing there.Design:Cross-sectional design.Setting:The study was conducted at a high school on the United States-Mexico border.Subjects:A sample of 445 primarily Hispanic students (ages 14-18).Measure:Perceived Disordered Neighborhood Stress Scale, Border Community and Immigration Stress Scale, and Normalization of Drug Trafficking Scale.Analysis:Logistic regression assessed the association between the socioenvironmental risk factors and past 30-day tobacco, alcohol, and marijuana use.Results:Participants with higher border community and immigration stress scores were significantly more likely to have used tobacco (adjusted odds ratio [aOR] = 1.41, P < .01) and alcohol (aOR = 1.31, P < .01) in the past 30 days. Perceived disordered neighborhood stress also was associated with past 30-day alcohol use (aOR = 1.46, P < .00). The normalization of drug trafficking was associated with past 30-day marijuana use (aOR = 1.45, P < .05).Conclusions:Public health practitioners, educational institutions, and policy makers should consider the economic and normative environment of the United States-Mexico border for future substance use prevention and risk reduction efforts targeting border adolescents.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-27T11:00:49Z
      DOI: 10.1177/0890117120927527
       
  • A Public Health Approach to Negative News Media: The 3-to-1 Solution
    • Authors: Tyler J. VanderWeele, Arthur C. Brooks
      Abstract: American Journal of Health Promotion, Ahead of Print.
      There is clear evidence that the prevalence of negative media reporting has increased substantially over the past years. There is evidence that this negative reporting adversely affects social interactions, and thereby also health and well-being outcomes. Given the wide reach of negative media reporting and the contagion of such reporting and the resulting interactions, the effects on health are arguably substantial. Moreover, there is little incentive at present for media outlets to change practices. A commitment of news outlets to report one positive story for every 3 negative stories, and of news consumers to restrict attention to outlets that do, could dramatically alter practices and, consequently, population health.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-26T11:47:18Z
      DOI: 10.1177/0890117120914227
       
  • Associations of Health Literacy and Menu-Labeling Usage With
           Sugar-Sweetened Beverage Intake Among Adults in Mississippi, 2016
    • Authors: Seung Hee Lee, Lei Zhang, Donald L. Rubin, Sohyun Park
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Examine association of health literacy (HL) and menu-labeling (ML) usage with sugar-sweetened beverage (SSB) intake among adults in Mississippi.Design:Quantitative, cross-sectional study.Setting:2016 Mississippi Behavioral Risk Factor Surveillance System data.Participants:Adults living in Mississippi (n = 4549).Measures:Outcome variable was SSB intake (regular soda, fruit drinks, sweet tea, and sports/energy drinks). Exposure variables were 3 HL questions (find information, understand oral information, and understand written information) and ML usage among adults who eat at fast-food/chain restaurants (user, nonuser, and do not notice ML).Analysis:Multinomial logistic regressions were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for SSB intake ≥1 time/d (reference: 0 times/d) associated with HL and ML.Results:In Mississippi, 46.8% of adults consumed SSB ≥1 time/d, and 26.9% consumed ≥2 times/d. The odds of consuming SSBs ≥1 time/d were higher among adults with lower HL (aOR = 1.7; 95% CI = 1.3-2.2) than those with higher HL. Among adults who ate at fast-food/chain restaurants, the odds of consuming SSBs ≥1 time/d were higher among nonusers of ML (aOR = 2.3; 95% CI = 1.7-3.1) and adults who did not notice ML (aOR = 1.8; 95% CI = 1.3-2.6) than ML users.Conclusion:Adults with lower HL and adults who do not use or notice ML consumed more SSBs in Mississippi. Understanding why lower HL and no ML usage are linked to SSB intake could guide the design of interventions to reduce SSB intake in this population.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-21T11:07:12Z
      DOI: 10.1177/0890117120927302
       
  • Change in Lifestyle Behaviors After Preconception Care: A Prospective
           Cohort Study
    • Authors: Meertien K. Sijpkens, Sabine F. van Voors, Ageeth N. Rosman, Lieke C. de Jong-Potjer, Semiha Denktaş, Birgit C.P. Koch, Loes C.M. Bertens, Eric A.P. Steegers
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the effects of preconception care (PCC) consultations by change in lifestyle behaviors.Setting and Intervention:Women in deprived neighborhoods of 14 Dutch municipalities were encouraged to visit a general practitioner or midwife for PCC.Sample:The study included women aged 18 to 41 years who had a PCC consultation.Design:In this community-based prospective cohort study, we assessed initiation of folic acid supplementation, cessation of smoking, alcohol consumption, and illicit drug use.Measures:Self-reported and biomarker data on behavioral changes were obtained at baseline and 3 months later.Analysis:The changes in prevalence were assessed with the McNemar test.Results:Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker-confirmed, P = .008) and for self-reported binge drinking (P = .007).Conclusion:Our study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-20T10:17:39Z
      DOI: 10.1177/0890117120927287
       
  • Influences of Cardiovascular Fitness and Body Fatness on the Risk of
           Metabolic Syndrome: A Systematic Review and Meta-Analysis
    • Authors: Junga Lee
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:The purpose of this meta-analysis was to investigate the associations between combined cardiovascular fitness, obesity, and the risk of metabolic syndrome.Data Sources:The MEDLINE and EMBASE databases were used to select relevant studies that included the relative risk (RRs) of metabolic syndrome based on the combined effects of cardiovascular fitness and obesity from January 1990 to July 2019.Study Inclusion and Exclusion Criteria:The inclusion criteria were providing the RRs for the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome. The exclusion criteria were review studies, duplicated studies, and no RRs reported for those associations.Data Extraction:All selected studies categorized levels of cardiovascular fitness (high cardiovascular fitness vs low cardiovascular fitness) and obesity (normal vs obesity) and directly extracted the RRs for the risk of metabolic syndrome from these data. All selected studies were cross-sectional studies.Data Synthesis:All RRs and 95% CIs from the selected studies were computed to find the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome.Results:A total of 8 studies were selected for this meta-analysis. Low cardiovascular fitness was associated with 3. Fifty-nine times increased metabolic syndrome risk regardless of obesity (3.59, 95% CI: 3.07-4.20; P = .00). And obesity was associated with 1.62 times increased metabolic syndrome risk regardless of cardiovascular fitness level (1.62, 95% CI: 1.32-1.98; P = .00). Lastly, the risk of metabolic syndrome decreased by 77% with high cardiovascular fitness regardless of obesity (0.23, 95% CI: 0.12-0.43; P = .00).Conclusions:The combined effects of cardiovascular fitness and obesity are important factors when determining metabolic syndrome risk. The minimum level of cardiovascular fitness is 8.39 metabolic equivalent (METs) for adults to lower the risk of metabolic syndrome. Enhanced cardiovascular fitness and maintaining normal weight should be recommended for individuals to reduce the risk of metabolic syndrome.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-20T09:41:21Z
      DOI: 10.1177/0890117120925347
       
  • The Importance of the Social Environment in Achieving High Levels of
           Physical Activity and Fruit and Vegetable Intake in African American
           Church Members
    • Authors: Natalia Heredia, Nga Nguyen, Lorna H. McNeill
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:African Americans experience a high burden of chronic diseases and cancers that are prevented and ameliorated with physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study is to identify individual, social, and neighborhood variables associated with African Americans attaining high levels of both behaviors.Design:This study is a cross-sectional analysis.Settings and Participants:Cohort of African Americans adults recruited from black churches in the Greater Houston area.Measures:Self-administered questionnaires collected in 2012 assessed correlates and behavioral outcome variables (PA and FV consumption). A combined 4-category behavioral outcome was created: high PA/high FV, low PA/high FV, high PA/low FV, and low PA/low FV.Analysis:Standard and stepwise multinomial logistic regression examined the association between the various variables and the behavioral outcome.Results:This sample (n = 1009) had a mean age of 49 years, was mostly female, and obese. Compared to the low PA/low FV intake group, the high PA/high FV intake group had significantly lower odds of individual-level variables (worrying about getting cancer, perceived stress, loneliness, and financial strain) and higher odds of social-level variables (social status, social cohesion, social organization involvement, and social norms). Only social-level variables remained significantly associated with higher odds of high PA/high FV intake in stepwise regression.Conclusion:These findings indicate that social influences may be most critical for high PA and FV intake in African Americans adults.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-15T09:24:14Z
      DOI: 10.1177/0890117120925361
       
  • The Association Between Quantitative Research Childhood Adversity and
           Self-Rated Physical Health in US College Students
    • Authors: Lisa M. Krinner, Jan Warren-Findlow, Jessamyn Bowling
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Adverse childhood experiences (ACEs) are related to unhealthy behaviors and poor self-rated health. Poor self-rated physical health (SRPH) is negatively associated with college students’ grades and overall academic achievement. This study examined the effects of ACEs on SRPH among undergraduate and graduate students (n = 568; 18-30 years) from a public university in the southeast.Methods:Students completed a cross-sectional online survey in October 2018. We conducted unadjusted and adjusted logistic regressions to examine the relationship between ACEs and SRPH among US college students.Results:Most participants reported 1 to 4 ACEs; one-fourth reported poor SRPH. Higher ACE exposure increased the odds for poor SRPH in a curvilinear relationship. Unadjusted results indicate ACE exposure increased risk between 82% and 228%, and that higher levels of resilience and adherence to diet and physical activity guidelines reduced risk for poor SRPH. In adjusted models, moderate ACE exposure was associated with 2.46 times greater odds (95% CI = 1.28-9.34) of reporting poor SRPH. Graduate students (odds ratio [OR] = .52, 95% CI = .27-.99) and those who met healthy diet (OR = .12, 95% CI = .02-.93) and physical activity recommendations (OR = .36, 95% CI = .23-.58) had reduced odds of poor SRPH.Conclusions:Students who have experienced ACEs are at a greater risk for poor health. Student health programs on campus should take a holistic approach by screening students for childhood adversity and promoting healthy behaviors to improve physical health.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-15T09:22:11Z
      DOI: 10.1177/0890117120925348
       
  • Impact of Prenatal Education on Breastfeeding Initiation Among Low-Income
           Women
    • Authors: Carolyn R. Ahlers-Schmidt, Hayrettin Okut, Jolynn Dowling
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine whether participants in the Baby Talk prenatal education program were more likely to initiate breastfeeding than nonparticipants.Design:Retrospective cohort study comparing women with a singleton pregnancy who were enrolled in Baby Talk with matched controls based on zip code, maternal age, race, language spoken, and payer source.Setting:Urban Midwest county.Sample:Baby Talk participants enrolled between November 2015 and December 2016 (n = 299) and matched controls identified through vital statistics records who were not enrolled (n = 1190).Intervention:A 12-hour prenatal education curriculum with 2.5 hours of breastfeeding content.Measures:The primary outcome was breastfeeding at hospital discharge as reported in vital statistics.Analysis:Likelihood-ratio χ2 and Fisher exact test were used to test the significant association between categorical variables.Results:Baby Talk participants were significantly more likely to initiate breastfeeding (93.65%) than matched nonparticipants (87.48%; P = .003). Non-Hispanic white and black Baby Talk participants were more likely to initiate breastfeeding than controls (96.15% vs 89.83%; 91.03% vs 77.02%, respectively; P < .05).Conclusions:Prenatal education has the potential to increase breastfeeding initiation among low-income women, especially non-Hispanic white and black. This study is limited as participants were from a single community, though Baby Talk was offered at 5 separate locations, and potentially from information bias as it was reliant on the accuracy of vital statistics data.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-14T10:10:19Z
      DOI: 10.1177/0890117120925342
       
  • A Focus Group Evaluation of Breathe Easier: A Mindfulness-Based mHealth
           App for Survivors of Lung Cancer and Their Family Members
    • Authors: Jenay M. Beer, Kasey N. Smith, Taylor Kennedy, George Mois, Dane Acena, David G. Gallerani, Karen Kane McDonnell, Otis L. Owens
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To explore attitudes and acceptance (i.e., intent for future adoption) of survivors of lung cancer and their family members toward a dyad-focused mHealth mindfulness-based intervention (MBI).Approach:Focus groups.Setting:Community hospital setting in South Carolina.Participants:Survivors n = 11 (M = 64.6 years; 73% female; 64% African American) of non-small cell lung cancer (stage I-IIIa) and their family members, n = 8 (M = 58.6 years; 38% female; 75% African American).Intervention:A fully functional prototype mHealth app to deliver a tailored MBI for survivors of lung cancer and their family members.Method:Semi-structured focus groups were conducted and assessed using thematic data analysis to identify the benefits, concerns, needs, and expectations of the app.Results:Convenience and health were the top benefits of using the app, while cost and difficulty of use were the top concerns. Survivors mentioned benefits more than their family members did. Participants felt positively about adding a community network to the app. Finally, participants expected to hear about Breathe Easier from their care provider.Conclusion:Participants perceived a benefit to having credible health information delivered through an mHealth app. Guidance and credible health information regarding lung cancer survivorship should be accessible and convenient for everyone impacted by the disease. Thus, future research should explore platforms for a virtual support system and understanding dissemination of mHealth apps through health care providers.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-14T09:44:36Z
      DOI: 10.1177/0890117120924176
       
  • Social Capital in the Response to COVID-19
    • Authors: Nicholas Pitas, Colin Ehmer
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Social capital provides a number of benefits during crisis scenarios, and high social capital communities respond more efficaciously than those with low social capital. With this in mind, we argue that the response to and recovery from the COVID-19 pandemic may be hampered in many American communities by deficiencies or disruptions in social capital brought about by physical distancing. Drawing on evidence from past crises, we recommend individuals, communities, and government institutions work to strengthen and expand social networks. A failure to do so will exact a toll in terms of human morbidity and mortality and exacerbate the current disaster.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-12T09:29:25Z
      DOI: 10.1177/0890117120924531
       
  • Neighborhood Poverty Histories and Physical Activity Among Children:
           Findings From the Geographic Research on Wellbeing (GROW) Study
    • Authors: Yeonwoo Kim, Catherine Cubbin
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Examine the association between neighborhood poverty histories and physical activity, and the moderation effect of family poverty and the mediation effect of built environments in such association.Design:A cross-sectional study of the Geographic Research on Wellbeing (2012-2013), a follow-up survey of statewide-representative Maternal and Infant Health Assessment (2003-2007).Setting:California.Participants:A total of 2493 women with children.Measures:Outcome measures are (1) daily leisure physical activity and (2) days of physical activity among children. An independent variable is poverty histories of census tract where the child resided. Mediators were mother-perceived social cohesion, mother-perceived neighborhood safety, distance to the closest park, and park acreage within 0.5 miles from the home. A moderator is family poverty.Analysis:Weighted regression analysis.Results:Family poverty was a significant moderator (P < .05); poor children in neighborhoods with long-term moderate poverty, long-term high poverty, or increasing poverty (vs long-term low poverty) had greater odds of daily physical activity (odds ratio [OR] = 1.46, 1.50, 1.66, respectively). Nonpoor children in neighborhoods with long-term moderate poverty or increasing poverty (vs long-term low poverty) were associated with decreased odds of daily physical activity (OR = 0.61 and 0.44, respectively). Mediation associations were insignificant (P> .05).Conclusion:The combined effect of family financial strains and neighborhood economic resources might prevent poor children in neighborhoods with long-term low poverty and decreasing poverty from utilizing health-promoting resources in neighborhoods.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-11T09:30:16Z
      DOI: 10.1177/0890117120923948
       
  • Corrigendum: Editor’s Desk: A Dashboard Approach to Demonstrating
           Value
    • Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-05-05T09:41:47Z
      DOI: 10.1177/0890117120927140
       
  • Differences in Consumption of NASEM Priority Nutrients and Food Groups by
           Race/Ethnicity Among Women Living in WIC-Participating Households
    • Authors: Meghan C. Zimmer, Veronica Rubio, Kristina W. Kintziger, Cristina Barroso
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine racial/ethnic differences in dietary intake of women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).Design:Cross-sectional study.Setting:Data from the US National Health and Nutrition Examination Survey.Participants:Women 19 to 50 years of age living in WIC-participating households.Measures:Nutrient/food group intake from one 24-hour dietary recall.Analysis:Multivariable linear regression was used to evaluate the relationship between race/ethnicity and nutrient/food group intake.Results:Compared to non-Hispanic white women, Hispanic women had lower dietary energy density (1.7 ± 0.1 vs 2.2 ± 0.1 kcal/g, P < .001), and better nutrient intake, including more folate (429 ± 20 vs 364 ± 29 µg, P = .024), fiber (20.1 ± 0.9 vs 13.6 ± 0.9 g, P ≤ .001), and potassium (2575 ± 78 vs 2251 ± 66 mg, P = .012). This may be related to greater consumption of total vegetables (1.67 ± 0.16 vs 1.17 ± 0.17 cup equivalents [c-eq], P = .029), including more red and orange vegetables (0.64 ± 0.11 vs 0.32 vs 0.09 c-eq, P = .013) and more legumes (0.17 ± 0.04 vs 0.07 ± 0.02 c-eq, P = .006). Both Hispanic and non-Hispanic black women consumed more sodium (Hispanic: P = .015; non-Hispanic black: P = .008), but less added sugars (Hispanic: P ≤ .001; non-Hispanic black: P = .015), than non-Hispanic white women.Conclusion:These findings highlight differences in dietary intake by race/ethnicity and can inform nutrition messages of WIC nutrition educators and dietitians.
      Citation: American Journal of Health Promotion
      PubDate: 2020-05-04T09:53:55Z
      DOI: 10.1177/0890117120920849
       
  • Interventions to Improve Mental Health, Well-Being, Physical Health, and
           Lifestyle Behaviors in Physicians and Nurses: A Systematic Review
    • Authors: Bernadette Mazurek Melnyk, Stephanie A. Kelly, Janna Stephens, Kerry Dhakal, Colleen McGovern, Sharon Tucker, Jacqueline Hoying, Kenya McRae, Samantha Ault, Elizabeth Spurlock, Steven B. Bird
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors.Data Source:A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library.Study Inclusion and Exclusion Criteria:Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers.Data Extraction:Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence.Data Synthesis:Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed.Results:Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity.Conclusion:Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-27T01:53:41Z
      DOI: 10.1177/0890117120920451
       
  • Who Uses Wearable Activity Trackers and Why' A Comparison of Former
           and Current Users in the United States
    • Authors: Ciarán P. Friel, Carol Ewing Garber
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Background:There has been an explosion in the use of wearable activity trackers (WATs), but we do not fully understand who wears them and why. This study’s purpose was to describe the characteristics of WAT users and to compare current and former users.Materials and Methods:A variety of internet-based resources (eg, Craigslist, Facebook) were used to recruit current and former WAT users. Respondents completed a web-based survey, where they provided information on sociodemographic characteristics, health, physical activity behavior, and about their WAT use.Results:Of the 2826 respondents who gave informed consent, 70.8% (n = 2002) met inclusion criteria for this analysis. Respondents ranged from 18 to 81 years old (mean 32.9 ± 12.2 standard deviation) with 73.8% women. Most were current WAT users (68.7%), and the average length of WAT use overall was 9.3 ± 9.7 months. On average, current users wore the device for 3.7 months longer than former users. Compared to current users, former users had a lower body mass index (1.2 kg/m2 less), reported fewer medical conditions, shared data from their device less often, and received the device as a gift more frequently.Conclusions:Current and former users varied in their reasons for using a WAT and how they used their device. Differences identified between these groups support further exploration of associations between WAT users’ profiles and their physical activity behavior.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-24T09:22:59Z
      DOI: 10.1177/0890117120919366
       
  • Authors’ Response to the Letter to the Editor: Parkrun and the Claim of
           “Elitism” in Paid-Entry Run/Walk Events
    • Authors: Verity Cleland, Meredith Nash, Suzi Claflin, Melanie J Sharman
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-04-22T09:17:29Z
      DOI: 10.1177/0890117120920446
       
  • Parkrun and the Claim of “Elitism” in Paid-Entry Run/Walk
           Events
    • Authors: James L. Nuzzo, James Steele
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-04-21T09:30:22Z
      DOI: 10.1177/0890117120920447
       
  • Genetic Exceptionalism and Precision Health Promotion
    • Authors: Paul E. Terry
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Are social determinants of health overrated' Is parenting overrated' Will the genetics revolution have the same influence on health behavior as powerful determinants such as culture or the environment' In this editorial, I posit that we will learn that genetic testing will have far greater benefits, and fewer harms, when done in conjunction with well-designed health education and lived experiences. I define precision health promotion as the personalized design of lived experiences that foster improved health and well-being for individuals within the context of their organizations, families, and communities. With the need for education and support to augment genetics information will come the need for unequivocal answers about who should know, and who has no business knowing, about your DNA test results.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-17T10:24:38Z
      DOI: 10.1177/0890117120908806
       
  • Development of a Tailored Behavioral Weight Loss Program for Veterans With
           PTSD (MOVE!+UP): A Mixed-Methods Uncontrolled Iterative Pilot Study
    • Authors: Katherine D. Hoerster, Lamont Tanksley, Tracy Simpson, Brian E. Saelens, Jürgen Unützer, Marissa Black, Preston Greene, Nadiyah Sulayman, Gayle Reiber, Karin Nelson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Veterans with post-traumatic stress disorder (PTSD) lose less weight in the Veterans Affairs (VA) weight management program (MOVE!), so we developed MOVE!+UP.Design:Single-arm pre–post pilot to iteratively develop MOVE!+UP (2015-2018).Setting:Veterans Affairs Medical Center.Participants:Overweight Veterans with PTSD (5 cohorts of n = 5-11 [N = 44]; n = 39 received ≥1 MOVE+UP session, with cohorts 1-4 [n = 31] = “Development” and cohort 5 [n = 8] = “Final” MOVE!+UP).Intervention:MOVE!+UP weight management for Veterans with PTSD modified after each cohort. Final MOVE!+UP was coled by a licensed clinical psychologist and Veteran peer counselor in 16 two-hour in-person group sessions and 2 individual dietician visits. Sessions included general weight loss support (eg, behavioral monitoring with facilitator feedback, weekly weighing), cognitive-behavioral skills to address PTSD-specific barriers, and a 30-minute walk to a nearby park.Measures:To inform post-cohort modifications, we assessed weight, PTSD, and treatment targets (eg, physical activity, diet), and conducted qualitative interviews.Analysis:Baseline to 16-week paired t tests and template analysis.Results:Development cohorts suggested improvements (eg, additional sessions and weight loss information, professional involvement) and did not lose weight (mean [M] = 1.8 lbs (standard deviation [SD] = 8.2); P = .29. Conversely, the final cohort reported high satisfaction and showed meaningful weight (M = −14 pounds [SD = 3.7] and 71% lost ≥5% baseline weight) and PTSD (M = −17.9 [SD = 12.2]) improvements, P < .05.Conclusions:The comprehensive, 16-week, in-person, cofacilitated Final MOVE!+UP was acceptable and may improve the health of people with PTSD. Iterative development likely produced a patient-centered intervention, needing further testing.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-12T09:13:49Z
      DOI: 10.1177/0890117120908505
       
  • Neighborhood Walkability and Overweight/Obese Weight Status Among Latino
           Adults
    • Authors: Rosenda Murillo, Layton M. Reesor-Oyer, Daphne C. Hernandez, Yu Liu, Ezemenari M. Obasi
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine whether aerobic physical activity mediates the association between neighborhood walkability and overweight/obesity weight status among Latino adults and whether the relative contribution of this pathway linking neighborhood walkability and aerobic activity varies by level of neighborhood social cohesion.Design:Cross-sectional.Setting:National Health Interview Survey (NHIS) 2015.Sample:NHIS adult Latino participants ≥18 years of age (n = 4303).Measures:Neighborhood walkability, neighborhood social cohesion, body mass index, and aerobic physical activity.Analysis:To determine whether physical activity mediates the relationship of walkability with overweight/obese weight status, a simple mediation analysis was conducted. Additionally, a moderated mediation analysis was conducted to test whether neighborhood social cohesion had a moderating effect on this relationship.Results:On average, the sample was 41 years old, 51% were male, 34% had less than a high school education, and 57% were foreign-born. Neighborhood walkability was statistically significantly related to overweight/obese weight status (standardized effect= −0.05, standard error [SE] = 0.02, P = .01). The interaction between walkability and neighborhood social cohesion on physical activity was not significant (standardized effect = 0.06, SE = 0.03, P = .09). Thus, the indirect effect of walkability on overweight/obesity weight status through physical activity was not shown to be modified by neighborhood social cohesion.Conclusion:Other neighborhood environment factors may play a role in the contribution of neighborhood walkability to overweight/obese weight status among Latinos.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:52:42Z
      DOI: 10.1177/0890117120907869
       
  • Prevalence of Frequent Mental Distress Among Illinois Adults With Chronic
           Conditions: Estimates From the Behavioral Risk Factor Surveillance System,
           2011 to 2017
    • Authors: Janae D. Price, Nancy L. Amerson, Kamil E. Barbour, Damilola V. Emuze
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The objective of this study was to examine frequent mental distress (FMD) by demographics, chronic conditions, and health risk factors among Illinois adults.Design:Descriptive analyses included χ2 and pairwise t tests to examine how FMD status differed by selected characteristics and Cox proportional hazards regression analysis to examine the association between FMD and chronic conditions and risk factors.Setting:Illinois Behavioral Risk Factor Surveillance System, 2011 to 2017 (n = 37 312).Participants:Adults who self-report FMD (n = 3455) were included.Measures:Prevalence of high blood pressure, coronary heart disease, chronic obstructive pulmonary disease, arthritis, asthma, high blood cholesterol, cancer, kidney disease, stroke, diabetes, weight status, physical activity status, smoking status, and drinking status.Results:A significantly higher FMD prevalence was found among females (11.7%; 95% confidence interval [CI]: 11.1-12.4), non-Hispanic blacks (13.4, 95% CI: 11.9-15.0), adults with less than a high school degree (14.4%; 95% CI: 12.6-16.3), adults with an annual income of less than $15 000 (21.4%; 95% CI: 19.4-23.5), and adults with a disability (23.3%, 95% CI: 21.9-24.7). Adjusted prevalence of FMD was significantly higher among adults for 8 of 10 chronic conditions and 4 of 5 health risk factors studied.Conclusions:Social stigmas related to depression and anxiety may lead to the underreporting of FMD. Chronic disease management programs in Illinois should consider integrating mental health services.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:51:02Z
      DOI: 10.1177/0890117120906960
       
  • The Impact of Health Promotion Interventions on Telomere Length: A
           Systematic Review
    • Authors: Shan Qiao, Yanping Jiang, Xiaoming Li
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objectives:The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging).Data Source:PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases.Study Inclusion and Exclusion Criteria:Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects.Data Extraction:Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines.Data Synthesis:Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead.Results:Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length.Conclusions:Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-27T12:48:33Z
      DOI: 10.1177/0890117120906958
       
  • Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco
           Product Use Among Underage US Students
    • Authors: Hunter Marion, William Garner, Alex Estrada, Christopher Moorer, Ixel Acosta-Velazquez
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age.Design:Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey.Setting:The survey was administered in public and private middle and high schools across the United States.Participants:The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period.Measures:The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade).Analysis:Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure.Results:Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing.Conclusions:Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-25T11:55:15Z
      DOI: 10.1177/0890117120905231
       
  • Nurses’ Perspectives on the Dismissal of Vaccine-Refusing Families From
           Pediatric and Family Care Practices
    • Authors: Michael J. Deem, Rebecca A. Kronk, Vincent S. Staggs, Denise Lucas
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Dismissal of families who refuse mandated childhood vaccines from pediatric practices has become more common among US pediatricians over the past 2 decades. While nurses (registered nurses [RNs] and advanced practice registered nurses [APRNs]) often are the first health-care professional to encounter parents’ vaccine hesitancy and serve as a primary source of information, there are no published data on nurses’ perspectives on dismissal as a response to vaccine refusal. This study examined nurses’ perspectives on dismissal of vaccine-refusing families from primary care practices.Design:Cross-sectional survey administered electronically from February to September 2018. Data analysis was conducted from November 2018 to March 2019.Setting:Data were collected electronically from a national sample of nurses.Subjects:A convenience sample of 488 primary care nurses (74% APRNs) was recruited and enrolled in the study through collaboration with 4 professional nursing associations.Measure and Analysis:A cross-sectional survey was conducted from February to September 2018. We explored correlates of nurses’ (n = 488) attitudes toward dismissal by modeling attitude scores as a function of practice and respondent characteristics. We also modeled odds of encountering vaccine refusal and odds of reporting dismissal of a vaccine-refusing family in the last 12 months, each as a function of respondents’ practice characteristics.Results:Eighty-four percent of respondents encountered vaccine refusal in the previous 12 months, and 22% reported that their practice had dismissed a vaccine-refusing family within the previous 12 months. Twenty-eight percent agreed/strongly agreed that they would dismiss or support a decision to dismiss families who refuse all vaccines, and 12% supported dismissal of families for refusal of some but not all vaccines. Thirty-nine percent of respondents disagreed/strongly disagreed with dismissing families who refuse all vaccines, and 50% disagreed/strongly disagreed with dismissal for refusal of some but not all.Conclusion:Almost all nurses working in primary care encounter vaccine refusal, and most consider all Centers for Disease Control and Prevention–recommended childhood vaccines to be important to public health. There is significant polarization of nurses’ attitudes toward the appropriateness of dismissal as a response to vaccine refusal. We recommend the development of professional nursing guidelines for responding to vaccine refusal. However, because there are no data on the community health impact of dismissal policies, we recommend further research on outcomes of dismissal policies to inform such guidelines.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:12:34Z
      DOI: 10.1177/0890117120906971
       
  • Development of a Wellness Committee Implementation Index for Workplace
           Health Promotion Programs in Small Businesses
    • Authors: Meagan C. Brown, Jeffrey R. Harris, Kristen Hammerback, Marlana J. Kohn, Amanda T. Parrish, Gary K. Chan, India J. Ornelas, Christian D. Helfrich, Peggy A. Hannon
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To construct a wellness committee (WC) implementation index and determine whether this index was associated with evidence-based intervention implementation in a workplace health promotion program.Design:Secondary data analysis of the HealthLinks randomized controlled trial.Setting:Small businesses assigned to the HealthLinks plus WC study arm.Sample:Small businesses (20-200 employees, n = 23) from 6 low-wage industries in King County, Washington.Measures:Wellness committee implementation index (0%-100%) and evidence-based intervention implementation (0%-100%).Analysis:We used descriptive and bivariate statistics to describe worksites’ organizational characteristics. For the primary analyses, we used generalized estimating equations with robust standard errors to assess the association between WC implementation index and evidence-based intervention implementation over time.Results:Average WC implementation index scores were 60% at 15 months and 38% at 24 months. Evidence-based intervention scores among worksites with WCs were 27% points higher at 15 months (64% vs 37%, P < .001) and 36% points higher at 24 months (55% vs 18%, P < .001). Higher WC implementation index scores were positively associated with evidence-based intervention implementation scores over time (P < .001).Conclusion:Wellness committees may play an essential role in supporting evidence-based intervention implementation among small businesses. Furthermore, the degree to which these WCs are engaged and have leadership support, a set plan or goals, and multilevel participation may influence evidence-based intervention implementation and maintenance over time.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:11:14Z
      DOI: 10.1177/0890117120906967
       
  • Effects of Intervention Characteristics on Willingness to Initiate a
           Weight Gain Prevention Program
    • Authors: Megan A. McVay, Marissa L. Donahue, JeeWon Cheong, Joseph Bacon, Michael G. Perri, Kathryn M. Ross
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine characteristics of weight gain prevention programs that facilitate engagement.Design:Randomized factorial experiment (5 × 2).Setting:Recruited nationally online.Participants:Adults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498).Measures:Participants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment.Analysis:Logistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs’ perceived effectiveness, respectively. Content analyses for open-ended text responses.Results:Participants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits.Conclusion:Targeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs.Study Preregistration: https://osf.io/b9zfh, June 19, 2018.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:08:14Z
      DOI: 10.1177/0890117120905709
       
  • Prevalence of Workplace Health Practices and Policies in Hospitals:
           Results From the Workplace Health in America Study
    • Authors: Laura Mulder, Brook Belay, Qaiser Mukhtar, Jason E. Lang, Diane Harris, Stephen Onufrak
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To provide a nationally representative description on the prevalences of policies, practices, programs, and supports relating to worksite wellness in US hospitals.Design:Cross-sectional, self-report of hospitals participating in Workplace Health in America (WHA) survey from November 2016 through September 2017.Setting:Hospitals across the United States.Participants:Random sample of 338 eligible hospitals participating in the WHA survey.Measures:We used previous items from the 2004 National Worksite Health Promotion survey. Key measures included presence of Worksite Health Promotion programs, evidence-based strategies, health screenings, disease management programs, incentives, work-life policies, barriers to health promotion program implementation, and occupational safety and health.Analysis:Independent variables included hospital characteristics (eg, size). Dependent characteristics included worksite health promotion components. Descriptive statistics and χ2 analyses were used.Results:Eighty-two percent of hospitals offered a wellness programs during the previous year with larger hospitals more likely than smaller hospitals to offer programs (P < .01). Among hospitals with wellness programs, 69% offered nutrition programs, 74% offered physical activity (PA) programs, and 84% had a policy to restrict all tobacco use. Among those with cafeterias or vending machines, 40% had a policy for healthier foods. Only 47% and 25% of hospitals offered lactation support or healthy sleep programs, respectively.Conclusion:Most hospitals offer wellness programs. However, there remain hospitals that do not offer wellness programs. Among those that have wellness programs, most offer supports for nutrition, PA, and tobacco control. Few hospitals offered programs on healthy sleep or lactation support.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:06:34Z
      DOI: 10.1177/0890117120905232
       
  • Join the Commune: A Controlled Study of Social Branding Influencers to
           Decrease Smoking Among Young Adult Hipsters
    • Authors: Pamela M. Ling, Nadra E. Lisha, Torsten B. Neilands, Jeffrey W. Jordan
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior.Design:Quasi-experimental controlled study.Setting:Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control).Participants:“Hipster” young adults (age 18-26) attending bars and nightclubs.Intervention:Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media.Measures:A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking.Analysis:Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions.Results:Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) (P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking.Conclusion:This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:05:14Z
      DOI: 10.1177/0890117120904917
       
  • Economic Evaluation of a Sun Protection Promotion Program in California
           Elementary Schools
    • Authors: Richard T. Meenan, Kim D. Reynolds, David B. Buller, Kim Massie, Julia Berteletti, Mary K. Buller, Jeff Ashley, Xia Liu
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Background:An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board–approved policy.Design:Program cost analysis: intervention delivery and practice implementation.Setting:California elementary schools (58 interventions and 60 controls). Principals at 52 intervention and 53 control schools provided complete implementation data.Participants:Principals completing pre-/postintervention surveys assessing practice implementation.Intervention:Phone-based 45-minute session with a project coach on practice implementation, follow-up e-mails/phone contacts, $500 mini-grant. Schools chose from a list of 10 practices for implementation: ultraviolet monitoring, clothing, hats, and/or sunscreen recommendations, outdoor shade, class education, staff training and/or modeling, parent outreach, and resource allocation. The duration of intervention was 20 months. Rolling recruitment/intervention: February 2014 to December 2017.Measures:Intervention delivery and practice implementation costs. Correlations of school demographics and administrator beliefs with costs.Analysis:Intervention delivery activities micro-costed. Implemented practices assessed using costing template.Results:Intervention schools: 234 implemented practices, control schools: 157. Twenty-month delivery costs: $29 310; $16 653 (per school: $320) for project staff, mostly mini-grants and coaching time. Administrator costs: $12 657 (per school: $243). Per-student delivery costs: $1.01. Costs of implemented practices: $641 843 for intervention schools (per-school mean: $12 343, median: $6 969); $496 365 for controls (per-school mean: $9365, median: $3123). Delivery costs correlated with implemented practices (0.37, P < .01) and total practice costs (0.37, P < .05). Implemented practices correlated with principal beliefs about the importance of skin cancer prevention to student health (0.46, P < .001) and parents (0.45, P < .001).Conclusion:Coaching of elementary school personnel can stimulate sun safety practice implementation at a reasonable cost. Findings can assist schools in implementing appropriate sun safety practices.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-14T01:46:57Z
      DOI: 10.1177/0890117120905217
       
  • Applying a Medical Wellness Group Visit Model to a Community Setting
           Yielding Weight Loss and Improved Laboratory Results
    • Authors: Kimberly R. Dong, Lila Flavin, Kerri Hawkins, Wayne Altman
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine the feasibility of applying a medical wellness group (WG) model to a community setting to improve cardiometabolic health.Design:This quasi-experiment was designed to compare individuals participating in the WG to participants in the control group who received general lectures on nutrition, physical activity, and sleep.Setting:A suburb north of Boston, Massachusetts.Participants:Forty-five adults were in the WG and 10 in the control group.Intervention:Fourteen weekly 90-minute sessions, led by a physician and dietitian, focusing on nutrition, physical activity, and sleep, compared to controls receiving two 30-minute general wellness lectures provided within 3 months.Measures:Pre- and postweight, waist circumference, hemoglobin A1C (HbA1c), and serum lipids; a survey measuring beliefs, attitudes, and intentions related to behavioral change.Analysis: T tests examined the mean change in biometric measurements. The Wilcoxon test was used to compare the ordinal questions in baseline and final survey results. The Mann-Whitney test was used to compare final survey results between groups.Results:The WG demonstrated desirable difference-in-difference between groups in weight (P < .001), waist circumference (P < .001), and total cholesterol (P = .03) compared to the control group. Mean change of HbA1c and triglycerides was not different between groups. Survey results showed that attitudes, perceived behavioral control, and feeling supported about wellness behaviors significantly improved from baseline to final visit in the WG (P = .002; P = .019, P = .006, respectively), but not among controls.Conclusion:Wellness groups are feasible and provide high levels of support and accountability that empower people to make behavioral changes to improve health.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:23:19Z
      DOI: 10.1177/0890117120905241
       
  • Does Adherence to Mediterranean Diet Mediate the Association Between Food
           Environment and Obesity Among Non-Hispanic Black and White Older US
           Adults' A Path Analysis
    • Authors: Meifang Chen, Virginia Howard, Kathy F. Harrington, Thomas Creger, Suzanne E. Judd, Kevin R. Fontaine
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aims to test the hypothesis that in addition to a direct effect of food environment on obesity, food environment is indirectly associated with obesity through consuming Mediterranean diet (MD).Design:Cross-sectional secondary data analysis.Setting:Nationwide community-dwelling residency.Sample:A total of 20 897 non-Hispanic black and white adults aged ≥45 years who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment during January 2003 and October 2007.Measures:The Modified Retail Food Environment Index (mRFEI; 0-100) was used as food environment indicator. The MD score (0-9) was calculated to indicate the dietary pattern adherence. Body mass index (BMI; kg/m2) was used to estimate obesity.Analysis:Path analysis was used to quantify the pathways between food environment, MD adherence, and obesity. Proper data transformation was made using Box–Cox power transformation to meet certain analysis assumptions.Results:The participants were from 49 states of the United States, with the majority (64.42%) residing in the South. Most of the participants were retired, female, white, married, having less than college graduate education, having annual household income ≤75 000, and having health insurance. The means of mRFEI was 10.92 (standard deviation [SD] = 10.19), MD score was 4.36 (SD = 1.70), and the BMI was 28.96 kg/m2 (SD = 5.90). Access to healthy food outlets (β = .04, P < .0001) and MD adherence (β = .08, P < .0001) had significant and inverse relationships with BMI, respectively. Mediterranean diet adherence mediated the relationship between food environment and obesity among a subpopulation who had an annual household income of
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:21:59Z
      DOI: 10.1177/0890117120905240
       
  • Student Tobacco Use Behaviors on College Campuses by Strength of Tobacco
           Campus Policies
    • Authors: Melinda J. Ickes, Amanda T. Wiggins, Mary Kay Rayens, Ellen J. Hahn
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine the association between strength of policy and self-reported tobacco use behavior, controlling for demographic characteristics, polytobacco use, knowledge of campus tobacco policy, and perceived policy compliance by others.Design:Cross-sectional, online survey.Setting:Ten participating State University of New York (SUNY) campuses; 5 with designated smoking/tobacco use areas and 5 with 100% tobacco-free policies.Subjects:Convenience sample of students from SUNY campuses: only tobacco users (N = 576 students) included for analysis.Measures:Items assessing tobacco use behaviors on campus, policy knowledge, and observation of others using tobacco on campus.Analysis: T tests and chi-square tests of association used to compare responses between tobacco users across campuses. Generalized estimating equations modeling used to evaluate predictors of tobacco use on campus; model estimated with students nested within campus.Results:Those on campuses without a comprehensive policy were more likely to report (in the past week) having seen others smoke on campus (98% vs 69%, P < .001), having personally smoked on campus (65% vs 36%, P < .001), and seeing others use tobacco products on campus (88% vs 67%, P < .001), compared to those on tobacco-free campuses.Conclusion:Tobacco-free campus policies provide numerous protective factors for tobacco users and nonusers. However, compliance strategies are imperative for intended policy success.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:20:39Z
      DOI: 10.1177/0890117120904015
       
  • Race/Ethnic Variations in Predictors of Health Consciousness Within the
           Cancer Prevention Context
    • Authors: Lucinda Nevarez, Shelly R. Hovick, Kimberly R. Enard, Stacy M. Lloyd, Lee Ann Kahlor
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Although the literature establishes a link between health consciousness (HC) and prevention behavior, less explored are the individual, social, and health characteristics that are associated with increased HC. Similarly, underexamined is the influence of race and ethnicity on the relationship of these characteristics to higher levels of HC.Design:This cross-sectional study aims to identify and assess the relative importance of factors associated with higher levels of HC, highlighting the role of race and ethnicity.Participants:Participants came from a national research panel survey (N = 1007).Measures:Participants completed a 4-item scale capturing key concepts of HC as well as questionnaires capturing demographic profiles, social support, social networking activities, and health status.Analysis:A stepwise multiple regression was used to identify significant predictors of HC.Results:Female and more educated participants report higher levels of HC. African American and Hispanic participants report higher levels of HC compared to white participants. Findings indicate social support, social network participation, education, cancer survivorship, and health status were positively associated with higher HC for the collective sample. However, results revealed variations in factors associated with higher HC when stratified by race/ethnicity.Conclusion:Findings suggest that interventions aiming to motivate cancer prevention behaviors within at-risk communities may find more success by incorporating factors that are aligned with increased HC among culturally diverse populations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-10T10:39:50Z
      DOI: 10.1177/0890117120904000
       
  • Stronger State School Nutrition Laws Are Associated With Healthier Eating
           Behaviors and Optimal Weight Status in US Adolescents
    • Authors: Namrata Sanjeevi, Leah M. Lipsky, Tonja R. Nansel, Denise Haynie, Aiyi Liu, Bruce Simons-Morton
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To investigate relationships of farm-to-school, school meal, and competitive food state laws with eating behaviors and weight status and to examine interaction between different types of state laws.Design:Observational cohort study.Settings:US adolescents.Participants:The NEXT study is a nationally representative sample of adolescents assessed annually for 7 years. Data (N = 2751) from students attending public schools from the first (W1) and third (W3) assessment waves (2010 and 2012), occurring during grades 10 and 12, respectively, of the NEXT study were included.Measures:Eating behaviors and weight status of adolescents were linked with Classification of Laws Associated with School Students scoring for state laws.Analysis:Regression analyses examined associations of laws with intake and weight status, accounting for complex survey design and school-level clustering.Results:Adolescents in states with strong farm-to-school laws had greater W1 whole fruit, lower soda, and snack intakes versus those in states with no laws. Strong school meal laws were associated with lower W1 soda intake. Adolescents in states with strong competitive food laws had lower soda intake and overweight/obesity odds than those in states with no laws in W3. Strong farm-to-school laws were inversely associated with W3 overweight/obesity odds only in states with strong competitive food laws.Conclusions:Stronger laws governing school nutrition were related to healthier eating behaviors and optimal weight status in this nationally representative sample of adolescents. Further, farm-to-school laws may be more effective in reducing obesity when combined with strong competitive food legislation.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-10T09:56:40Z
      DOI: 10.1177/0890117120902346
       
  • Community Program Activities Predict Local Tobacco Policy Adoption in
           Florida Counties
    • Authors: Lauren E. Grattan, Carol L. Schmitt, Lauren Porter
      Abstract: American Journal of Health Promotion, Ahead of Print.
      The Bureau of Tobacco Free Florida’s community program funds county-level grantees who promote local policy change through activities that educate the public, policy-makers, and decision-makers. There is robust literature linking tobacco control policies such as smoke-free air laws and tax increases to reductions in tobacco use. There is less evidence documenting the local activities programs conduct to achieve local policy change. In the current study, we used a quantitative model to assess the relationship between community tobacco control activities and local tobacco policy adoption. Grantee activities and policy adoption for each county are recorded in a database. To evaluate the community program, we compiled inputs and used a fixed-effects negative binomial regression to examine the relationship between grantee activities and policy adoption across all 67 community-based programs in Florida from 2010 to 2017 and analyzed the data in 2018. Measures included categories of policies (organization policies and jurisdiction policies) and community-based activities associated with tobacco control programs. Organization policy (school and business policy) and jurisdiction policy (county or city ordinances, proclamations, and resolutions) were dependent on partner meetings (incident rate ratio [IRR] = 1.03, confidence interval [CI] = 1.00-1.07 and IRR = 1.04, CI = 1.01-1.07, respectively) and local decision-maker communication (IRR = 1.01, CI = 1.00-1.03 and IRR = 1.05, CI = 1.03-1.07, respectively). Jurisdiction policy was also dependent on media advocacy (IRR = 1.07, CI = 1.02-1.12) and state policy-maker education (IRR = 1.16, CI = 1.06-1.26. Community outreach was negatively associated with jurisdiction policy (IRR = 0.97, CI = 0.94-0.99), and data collection was negatively associated with organization and jurisdiction policy (IRR = 0.97, CI = 0.95-1.00 and IRR = 0.97, CI = 0.95-1.00, respectively). Results from the study demonstrate that the type and timing of community grantee activities may influence local tobacco control policy adoption.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T12:02:48Z
      DOI: 10.1177/0890117120904005
       
  • Sociodemographic Correlates of Food Insecurity Among New York City Tobacco
           Users
    • Authors: Christina N. Wysota, Scott E. Sherman, Elizabeth Vargas, Erin S. Rogers
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To identify rates and sociodemographic correlates of food insecurity among low-income smokers.Design:Cross-sectional analysis of baseline survey data from a randomized controlled trial (N = 403) testing a smoking cessation intervention for low-income smokers.Setting:Two safety-net hospitals in New York City.Sample:Current smokers with annual household income
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T12:01:05Z
      DOI: 10.1177/0890117120904002
       
  • Use of Patient Portals of Electronic Health Records Remains Low From 2014
           to 2018: Results From a National Survey and Policy Implications
    • Authors: Y. Alicia Hong, Shaohai Jiang, Piper Liping Liu
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To investigate the trend of patient portal use in the general population and the barriers to adoption.Participants:We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018.Measures:Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables.Analysis:Logistic regression analyses were conducted separately for the 3 iterations of HINTS.Results:The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations.Conclusion:The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients’ confidence in data safety.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T11:44:10Z
      DOI: 10.1177/0890117119900591
       
  • Breakfast Positively Impacts Cognitive Function in College Students With
           and Without ADHD
    • Authors: Elizabeth T. Brandley, Kathleen F. Holton
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To compare the effects of a nutritionally balanced breakfast on cognitive function in college students with and without attention-deficit/hyperactivity disorder (ADHD).Design:Pre–post dietary intervention.Setting:University.Sample:College students aged 18 to 25 years with (n = 19) and without (n = 27) ADHD.Intervention:Participants completed computerized cognitive assessment after an overnight fast and again 1 hour after consuming a nutritionally balanced breakfast shake.Measure:CNS Vital Signs computerized cognitive testing.Analysis:Chi-square tests were used to compare categorical variables, and nonparametric Wilcoxon rank sum and signed rank tests were used to compare continuous data between and within groups (respectively). Multivariable logistic regression was used to estimate the likelihood of ADHD based on cognitive improvement from breakfast consumption, after adjusting for age, sex, GPA, and year in school.Results:A significant proportion of those with and without ADHD (47% and 33%, respectively) reported not typically eating breakfast at baseline. One hour after consuming a balanced breakfast shake, both groups demonstrated improvements in 4 cognitive function domains. Those with ADHD were more likely to improve in reaction time than those without ADHD (odds ratio [95% confidence interval] = 1.07 [1.00-1.15], P = .04).Conclusions:The results of this pilot study suggest that college students with and without ADHD may benefit cognitively from a balanced breakfast. More research is needed to confirm these findings.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-04T10:53:04Z
      DOI: 10.1177/0890117120903235
       
  • Exploring the Relationship Between MyPlate Knowledge, Perceived Diet
           Quality, and Healthy Eating Behaviors Among Adolescents
    • Authors: Miranda Westfall, Sarah E. Roth, Monique Gill, Alec M. Chan-Golston, Lindsay N. Rice, Catherine M. Crespi, Michael L. Prelip
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:MyPlate is the current dietary guidance icon meant to communicate healthy eating patterns. The purpose of this study is to evaluate knowledge of MyPlate nutrition education messages among middle school students and its association with dietary intake and perceived diet quality.Design:Secondary analysis of cross-sectional data.Settings:Survey of eighth-grade students from 16 middle schools in California.Subjects:A total of 3521 eighth-grade students.Measures:MyPlate knowledge was assessed with 3 questions asking how much of the plate in a typical meal should be (1) fruits and vegetables, (2) grains, and (3) proteins. A brief food frequency questionnaire measured intake of fruits, vegetables, sweets, salty snacks, fast-food, and sugar-sweetened beverages (SSBs) over the past 7 days. Students self-rated their diet quality as poor, fair, good, or excellent.Analysis:Hierarchical logistic regression models controlling for gender, ethnicity, and socioeconomic status.Results:Only 11% of students answered all MyPlate questions correctly. MyPlate knowledge was associated with 65% higher odds of not consuming SSBs, but 46% lower odds of not consuming sweets. MyPlate knowledge was not associated with adolescents’ perceived diet quality or intake of salty snacks, fruits, or vegetables.Conclusion:Knowledge of nutrition education messages communicated by the MyPlate dietary guidance icon is limited among adolescents. The association between MyPlate knowledge and lower consumption of SSBs is encouraging, given the strong association between SSBs and childhood obesity.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-31T09:17:16Z
      DOI: 10.1177/0890117120901430
       
  • Development and Evaluation of a Cancer Literacy Intervention to Promote
           Mammography Screening Among Navajo Women: A Pilot Study
    • Authors: Pamela S. Sinicrope, Mark C. Bauer, Christi A. Patten, Martha Austin-Garrison, Linda Garcia, Christine A. Hughes, Martha J. Bock, Paul A. Decker, Kathleen J. Yost, Wesley O. Petersen, Lydia P. Buki, Edward R. Garrison
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Develop and evaluate a mammography intervention that provides hope about cancer prevention and treatment.Design:Pilot randomized controlled trial.Setting:Two communities on the Navajo Nation.Participants:Navajo women and support persons.Intervention:Both groups received standard care: one home visit discussing mammography pros/cons and barriers. The treatment group received an intervention based on Navajo language via an additional home visit with health education materials (written and oral) in English and Navajo, including a Navajo Cancer Glossary with a new descriptive phrase for cancer.Analysis:Between control and intervention conditions, we compared baseline sociodemographics; changes from baseline to 3 months on mammography completion and breast cancer literacy scores.Measures:(1) intervention feasibility; (2) self- and clinic-reported mammography screening completion; (3) breast cancer literacy.Results:A total of 25 participants were randomly assigned (13 treatment, 12 control), with 7 support persons in each arm. Mean age was 53 years, 90% had a high school degree or higher, 86% spoke Navajo and English. At 3 months, 44% had a clinically verified mammogram. Mammography completion was 57% among those with a support person and 27% among those without (P = .14). Intervention women reported more breast cancer beliefs consistent with mammography (P = .015).Conclusions:Increases in breast cancer beliefs consistent with mammography show promise. Findings highlight a need to tailor education materials to Navajo culture/language and focus on enhancing support.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-28T02:00:25Z
      DOI: 10.1177/0890117119900592
       
  • Job-Related Characteristics and Obesity in Australian Employees: Evidence
           From a Longitudinal Nationally Representative Sample
    • Authors: Syed Afroz Keramat, Khorshed Alam, Jeff Gow, Stuart J. H. Biddle
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:This study aimed to examine the longitudinal association between 9 job-related characteristics and obesity among Australian employees using a nationally representative sample.Design:Longitudinal research design.Setting:Workplace.Participants:This study was conducted by pooling 2 cross-sectional surveys of nationally representative longitudinal data collected across 2-time points in 2013 and 2017. This study limited the sample to current employees aged 15 to 64 years. The total number of observation included in the analysis is 16 980 of 11 521 employees.Measures:The outcome variable is weight status and the main exposure variables are 9 job-related characteristics (work hours per week, work schedule, job type, employment contract type, firm size, supervisory responsibility, paid sick leave, self-perceived job stress, and self-perceived job insecurity). Generalized estimating equation logistic regression was employed to explore the association between job-related characteristics and obesity.Results:This study found that 59% of Australian employees were either overweight or obese. Employees working more than 40 hours per week were 1.11 times (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.03-1.21) and 1.07 times (OR: 1.07, 95% CI: 1.01-1.13) more prone to become overweight and obese, respectively, compared to their counterparts who work 31 to 40 hours per week. The study also revealed that self-perceived job insecurity was positively associated with obesity (OR: 1.03, 95% CI: 1.02-1.04). However, this study did not find evidence that work schedule, job type, employment contract, firm size, supervisory role, paid sick leave, and self-perceived job stress were associated with obesity.Conclusions:Working more than 40 hours per week and self-perceived job insecurity were significantly associated with obesity among Australian employees. A better understanding of why prolonged work hours and self-perceived job insecurity are associated with obesity may help policy makers to implement workplace wellness policies and for employers to take measures to tackle the obesity problem of their employees.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-27T08:00:57Z
      DOI: 10.1177/0890117119901093
       
  • Physical Activity Surveillance Using Wearable Activity Monitors: Are US
           Adults Willing to Share Their Data'
    • Authors: Eric T. Hyde, John D. Omura, Janet E. Fulton, Andre Weldy, Susan A. Carlson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Wearable activity monitors (wearables) have generated interest for national physical activity (PA) surveillance; however, concerns exist related to estimates obtained from current users willing to share data. We examined how limiting data to current users who are willing to share data associated with PA estimates in a nationwide sample.Design:Cross-sectional web-based survey.Setting:US adults.Subjects:In total, 942 respondents.Measures:The 2018 Government & Academic Omnibus Survey assessing current wearable use, willingness to share data with various people or organizations, and PA levels.Analysis:Estimated the prevalence of current wearable use; current users’ willingness to share data with various people or organizations; and PA levels overall, among current users, and among current users willing to share their data.Results:Overall, 21.7% (95% confidence interval [CI]: 19.1-24.5) of US adults reported currently using a wearable. Among current users, willingness to share ranged from 40.1% with a public health agency to 76.3% with their health-care provider. Overall, 62.2% (95% CI: 58.9-65.3) of adults were physically active. These levels were similar between current users (75.0%, 95% CI: 68.3-80.7) and current users willing to share their data (75.3%, 95% CI: 67.9-81.5).Conclusion:Our findings suggest that using data from wearable users may overestimate PA levels, although reported willingness to share the data may not compound this issue.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-20T10:06:21Z
      DOI: 10.1177/0890117119900587
       
  • Being Safe Versus Being Safer: Mask Guidance and Hard-Earned Lessons From
           the AIDS Pandemic
    • Authors: Paul E. Terry
      First page: 475
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-04-22T09:18:49Z
      DOI: 10.1177/0890117120922037
       
  • Integration of Mixed Methods in Community-Based Participatory Research:
           Development of a Disease Prevention Intervention for Ultra-Orthodox Jewish
           Women
    • Authors: Elisheva Leiter, Adi Finkelstein, Milka Donchin, Keren L. Greenberg, Osnat Keidar, Sima Wetzler, Sara Siemiatycki, Ronit Calderon-Margalit, Donna R Zwas
      First page: 479
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To describe the development of the first disease prevention intervention with ultra-Orthodox Jewish (UOJ) women in Israel using mixed methods and community-based participatory research (CBPR).Design:This collaborative, 7-staged development process used an exploratory sequential mixed methods design integrated into a community-based participatory approach.Setting:The UOJ community in Israel, a high-risk, low socioeconomic, culturally insular minority that practices strict adherence to religious standards, maintains determined seclusion from mainstream culture and preserves traditional practices including extreme modesty and separation between the sexes.Participants:Women from a targeted UOJ community in Israel with distinct geographic, religious, and cultural parameters. These included 5 key informant interviewees, 5 focus groups with 6 to 8 participants in each, a cluster randomized sample of 239 questionnaire respondents (an 87% response rate), and 11 steering committee participants.Method:Qualitative data were analyzed through Interpretative Phenomenological Analysis by 2 researchers. Quantitative data were collected via questionnaire (designed based on qualitative findings) and analyzed utilizing descriptive statistics.Results:Barriers to health behavior engagement and intervention preferences were identified. The final intervention included walking programs, health newsletters, community leader trainings, teacher and student trainings, and health integration into schools.Conclusion:Utilizing mixed methods in CBPR improved cultural tailoring, potentially serving as a model for intervention design in other difficult to access, low socioeconomic, and culturally insular populations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-03T09:55:08Z
      DOI: 10.1177/0890117120906965
       
  • Ten Modifiable Health Risk Factors and Employees’ Medical
           Costs—An Update
    • Authors: Ron Z. Goetzel, Rachel Mosher Henke, Michael A. Head, Richele Benevent, Kyu Rhee
      First page: 490
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To estimate the relationship between employees’ health risks and health-care costs to inform health promotion program design.Design:An observational study of person-level health-care claims and health risk assessment (HRA) data that used regression models to estimate the relationship between 10 modifiable risk factors and subsequent year 1 health-care costs.Setting:United States.Participants:The sample included active, full-time, adult employees continuously enrolled in employer-sponsored health insurance plans contributing to IBM MarketScan Research Databases who completed an HRA. Study criteria were met by 135 219 employees from 11 employers.Measures:Ten modifiable risk factors and individual sociodemographic and health characteristics were included in the models as independent variables. Five settings of health-care costs were outcomes in addition to total expenditures.Analysis:After building the analytic file, we estimated generalized linear models and conducted postestimation bootstrapping.Results:Health-care costs were significantly higher for employees at higher risk for blood glucose, obesity, stress, depression, and physical inactivity (all at P < .0001) than for those at lower risk. Similar cost differentials were found when specific health-care services were examined.Conclusion:Employers may achieve cost savings in the short run by implementing comprehensive health promotion programs that focus on decreasing multiple health risks.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-16T05:07:16Z
      DOI: 10.1177/0890117120917850
       
  • Attending After-School Physical Activity Club 2 Days a Week Attenuated an
           Increase in Percentage Body Fat and a Decrease in Fitness Among Adolescent
           Girls at Risk for Obesity
    • Authors: Lorraine B. Robbins, Jiying Ling, Fujun Wen
      First page: 500
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the effect of a 17-week intervention, including an after-school physical activity (PA) club 3 d/wk, on moderate-to-vigorous physical activity (MVPA), body mass index (BMI) z score, percentage body fat (%BF), and cardiorespiratory fitness (CRF) among fifth to eighth grade girls having a BMI z score ≥0, and explore whether intervention outcomes varied by club attendance (1 vs 2 vs 3 d/wk).Design:Secondary analysis of data from a group randomized controlled trial (N = 1519, 10- to 15-year-old girls: n = 753 intervention; n = 766 control).Setting:Twenty-four Midwestern US schools (n = 12 intervention; n = 12 control).Sample:Subsample (n = 1194 girls) from trial’s intervention (n = 593 girls) and control (n = 601 girls) groups having BMI z scores ≥0.Measures:Moderate-to-vigorous physical activity (min/h), BMI z score, %BF, and CRF ([math]: mL/kg/min) were estimated at baseline and postintervention.Analysis:Linear mixed-effect models.Results:Intervention group gained less %BF (B = −0.35, P = .016), and their CRF decreased less (B = 0.22, P = .010) than the control. Marginally significant findings showed girls attending the club an average of 1 d/wk had greater increases in %BF (B = 0.33, P = .087) and MVPA (B = 0.20, P = .083) and a greater decrease in CRF (B = −0.20, P = .061) than girls attending 3 d/wk. No differences occurred between girls who attended 2 versus 3 d/wk for any outcomes.Conclusions:The intervention attenuated an increase in %BF and a decrease in CRF among girls at risk for obesity from baseline to postintervention. Offering the after-school PA club 2 d/wk may be adequate for achieving outcomes.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-02T09:57:00Z
      DOI: 10.1177/0890117120915679
       
  • Physical Activity, Screen Time, and Sleep Duration Among Youth With
           Chronic Health Conditions in the United States
    • Authors: Sean Healy, John Foley, Justin A. Haegele
      First page: 505
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To compare the degree to which youth with and without chronic conditions in the United States met physical activity (PA), screen time, and sleep duration guidelines.Design:A cross-sectional study using data from the 2016 National Survey of Children’s Health.Participants:A total of 24 405 youth (aged 10-17 years) with and without 1 of 19 prevalent chronic health conditions who participated in the 2016 National Survey of Children’s Health.Measures:Parents reported on the time spent by their children in PA, screen time, and sleep.Analysis:Descriptive and bivariate analyses were conducted to estimate and compare health behavior guideline adherence rates among children with and without chronic conditions.Results:Overall, 18.7% of children with chronic conditions did not meet any health behavior guidelines compared to 15.6% of children without chronic conditions. Children with hearing impairments, diabetes, and depression were most likely to not meet any health behavior guidelines (27.9%, 25.4%, and 21.7%, respectively). Of the 3 guidelines, children with and without chronic conditions were least likely to meet the PA guideline (18.6% and 21%, respectively).Conclusions:This study identifies specific groups of children with chronic conditions that are most at risk of not meeting health behavior guidelines. The findings highlight specific behaviors in most need of intervention for children with chronic conditions; PA was identified as the most frequently unmet guideline. Overall findings suggest a need for a more integrated, holistic view of health promotion for children with chronic conditions.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-01T09:32:38Z
      DOI: 10.1177/0890117120915687
       
  • Implementation Outcomes Following Participation in a Large-Scale Healthy
           Workplace Program Conducted Across Multiple Worksites
    • Authors: Zenobia Talati, Carly Grapes, Emily Davey, Trevor Shilton, Simone Pettigrew
      First page: 512
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To measure implementation outcomes of a freely available workplace health promotion program (Healthier Workplace Western Australia [HWWA]) that provides employees with services and supports to make changes in their workplaces.Setting:Western Australian workplaces.Subjects:Employees accessing HWWA services.Intervention:A range of services (training sessions, tailored advice, grant schemes, online resources) were offered relating to nutrition, physical activity, smoking, alcohol consumption, and mental health.Design/Measures:Of the 1627 individuals e-mailed 6 months after participation in HWWA, 345 (21%) individuals who recalled accessing one or more services completed a survey assessing the number and type of changes they had implemented and the perceived barriers to doing so.Analysis:Negative binomial regressions and one-way analysis of variances assessed whether respondent characteristics or number of services used was associated with the number and types of changes made. A qualitative analysis of the perceived barriers was also conducted.Results:The majority of respondents (86%) reported implementing one or more changes. Greater perceived responsibility/authority to make change (β = .56, P < .01), perceived support from coworkers (β = .23, P < .05), and number of HWWA services used (β = .04, P < .05) were positive predictors of the number of changes made. Frequently reported barriers included cost/budget restrictions, lack of management support, and resistance from staff.Conclusion:The HWWA program facilitated implementation of various healthy workplace initiatives across the organizations represented in the evaluation.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-03T09:29:30Z
      DOI: 10.1177/0890117120911504
       
  • Is Exercise a Useful Intervention in the Treatment of Alcohol Use
           Disorder' Systematic Review and Meta-Analysis
    • Authors: Fatih Gür, Ganime Can Gür
      First page: 520
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objectives:This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes.Data Sources:PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases.Study Inclusion and Exclusion Criteria:Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD.Data Extraction:This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines.Data Synthesis:Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week).Results:The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression.Conclusions:Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-26T09:47:14Z
      DOI: 10.1177/0890117120913169
       
  • Interventions to Improve Sexual and Reproductive Health in US Active Duty
           Military Service Members: A Systematic Review
    • Authors: Sara E. Vargas, Colby Norris, Ryan R. Landoll, Baylee Crone, Madison F. Clark, Jeffrey D. Quinlan, Kate M. Guthrie
      First page: 538
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To identify and describe behavioral interventions to promote sexual and reproductive health among US active duty military service members.Data Sources:Systematic searches of PubMed, CINAHL, and PsychINFO (N = 1609 records).Inclusion Criteria:English-language articles published between 1991 and 2018 and retrieved using search terms related to military service, interventions, and sexual and reproductive health.Exclusion Criteria:Articles excluded if not empirically based, not published in peer-reviewed journals, did not sample active duty US military personnel, and did not examine the effectiveness of specified preventive sexual or reproductive health intervention(s).Data Extraction:Teams of paired authors extracted study rationale; aims; design; setting; description of the intervention; measures; sample demographics; clinical, behavioral, and psychosocial outcomes; and conclusions.Data Synthesis:Given the heterogeneity of studies, narrative synthesis was performed.Results:Fifteen articles met inclusion criteria: 10 focused on sexually transmitted infection (STI) acquisition and/or unintended pregnancy and 5 on sexual assault. Studies that assessed clinical outcomes found that interventions were associated with lower rates of STIs and/or unintended pregnancy. Significant effects were found on knowledge-related outcomes, while mixed effects were found on attitudes, intentions, and behaviors.Conclusions:Current evidence on the effectiveness of sexual and reproductive health interventions in the US military is limited in quality and scope. Promoting sexual and reproductive health in this population is critical to maintaining well-being among servicemembers, their families, and the communities surrounding military installations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:54:42Z
      DOI: 10.1177/0890117120908511
       
  • Correlates of Infrequent Plain Water Intake Among US High School Students:
           National Youth Risk Behavior Survey, 2017
    • Authors: Sohyun Park, Stephen Onufrak, Angie Cradock, Anisha Patel, Christina Hecht, Caitlin Merlo, Heidi M. Blanck
      First page: 549
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine factors associated with frequency of plain water (ie, tap, bottled, and unflavored sparkling water) intake among US high school students.Design:Quantitative, cross-sectional study.Setting:The 2017 national Youth Risk Behavior Survey data.Subjects:US high school students with plain water intake data (N = 10 698).Measures:The outcome was plain water intake. Exposure variables were demographics, academic grades, and behavioral characteristics.Analysis:We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for factors associated with infrequent plain water intake (
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-18T10:16:28Z
      DOI: 10.1177/0890117120911885
       
  • Does Exposure to the Choose Water Campaign Increase Parental Intentions to
           Promote More Water and Less Sugar-Sweetened Beverage Consumption'
    • Authors: Julia I. Caldwell, Brenda Robles, Rachel Tyree, Renee White Fraser, Kelly A. Dumke, Tony Kuo
      First page: 555
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To assess if exposure to the Choose Water public health media campaign increased parents’ intentions to promote healthier beverage consumption in their household.Design:A cross-sectional evaluation administered post-campaign.Setting:A 2017 internet panel survey in Los Angeles County, California.Participants:The survey included 499 parents of young children.Intervention:The Choose Water media campaign included digital media and out-of-home advertisements (eg, transit shelters, interiors of buses) in both English and Spanish.Measures:Dichotomous outcome variables were parental intentions to give child(ren) (1) more water and (2) less sugar-sweetened beverage consumption in their households. The independent variable was campaign exposure, categorized as no exposure, exposed but did not discuss visual, and exposed and discussed visual with someone.Analysis:Descriptive, bivariate, and multivariable logistic regressions.Results:Among those who were exposed and discussed a campaign visual, the adjusted odds of intending to promote water consumption were 2.82 times greater than for those who reported no exposure (95% confidence interval [CI]: 1.46-5.46). Similar odds to promote less sugar-sweetened beverage consumption were observed for those who were exposed and discussed a campaign visual (adjusted odds ratio: 3.27, 95% CI: 1.76-6.08). Those with the lowest educational attainment discussed the visual(s) less (10.5%).Conclusion:Word of mouth may enhance health messaging by allowing time for intended audiences to process campaign content within their interpersonal network.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-03T10:04:53Z
      DOI: 10.1177/0890117120908785
       
  • Wellness Program Nonparticipation and Its Association With Employee
           Turnover
    • Authors: Kristi Rahrig Jenkins, Bruce W. Sherman
      First page: 559
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study examines the association between nonparticipation in wellness activities and employee turnover risk.Design:Retrospective, cross-sectional analysis.Setting:Large university in the Midwestern United States.Participants:Employees with continuous employment during 2016 and complete human resources and wellness program data (n = 34 405).Methods:Demographic, health risk assessment (HRA), and wellness program participation data were collected in 2016 and paired with administratively recorded turnover status from 2017. For the multivariate analyses, logistic regression models were used.Results:There were statistically significant associations between various socioeconomic and demographic characteristics (gender, age, race, wage, union and faculty status, and health score) with turnover status. Also, all 3 participation levels (participated in the HRA only, participated in the HRA and wellness programming, and participated in wellness programming only) had lower odds of experiencing turnover compared to nonparticipants (participated in the HRA only [adjusted odds ratio, AOR: 0.89; confidence interval, CI: 0.80-0.99], participated in wellness program(s) only [AOR: 0.77; CI: 0.62-0.95] and participated in both the HRA and program(s) [AOR: 0.82; CI: 0.74-0.91], respectively).Conclusion:Employee participation in wellness program activities appears to represent a measure of engagement with work. Nonparticipation in these programs is associated with increased risk of employment turnover in the subsequent year.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-27T12:51:00Z
      DOI: 10.1177/0890117120907867
       
 
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